HomeMy WebLinkAboutBuilding Permit 99-0657
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
.
10 -ze-"!f1
A.J7
45?bo ~ ~
CONTR.
PERMIT NO.
99- ~ {, '5"'7
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GA2t~~IR TST
o MECH FINAL , _ .~ (
~;,., A~
6
(6- ;U])
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO'Ll.C CAALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ( OWner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTJ
16. PROJECT COSTNALUE
!lBSV
J;;L8'~N /qOr'1
,
information on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
t all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
t for j ~rmore, I hereby agree that the:;l '{}07 ~qe2f~enter upon the property to ~rr;;;:di,ini~q
UcenseNo. Date
~~
QAII;, RI=r.I;I"I=f!
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12SI~BtbS /klV'fQh
3. LEGAL DESCRIPTION
1. DATE
~I rl.;r
LOT
ADDITION
tJN!/-e $);.
I
.5 f1Ott:..E S
PID 2E~Ot:i/- 005~ 0
BLOCK
141~
(Address)
S"4'trJ.e Q S
(Address)
(Tel. No.) "1</7- ft:, ~~
I'l 0<:>11 ~
(Name)
(Tel. No.)
15. ARCHITECT
6. BUILDER
(Name)
(Tel. No.),/IfS;-78B I
JBftd.~~lZf (~
Deck [j Ae-roofing')( Porch 0
Finish Anie a Re-siding 0 Finish Basement 0
(Address)
51wt 1/ kc/+er t Onqru(fjtt;n
7. TYPE OF WORK Fireplace 0 Septic 0
New Construction 0 Alterations 0 Addition 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
110. CULVERT SIZE
Yes No
I hereby certify that I have fumishe
the above mentioned property an
buildi iclal can revoke this P
X
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
q9-~::>7
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ...................................,..... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
SETBACKS: Required
Actual
Back
Side
Side
Front
- BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2nJD.VV
USE OF BUILDING
.e.e S I"f/ /L
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
7t-f.l\
Plan Check Fee ..................... ........ $
State Surcharge ............................. $
Penalty ....................................... $
).Lr
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Plumbing Permit Fee ....................... <I:
Mechanical Permit Fee ..................... <I:
Pressure Reducer .......................... $
Meter Hom ... .... .... ................. ....... ~
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... (t
Water Tap ................................... $.
Builder's Deposit ............................ $
Other ......................................... $
Total Due ............................., $ -/".cJ{)
Paid '1 (, . fi'"U Receipt No. 3 531 J
Issued . Date ,,/, / q "I By "r11l1v .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning OrdilJance and may proceed L';;ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~;: TlJ;JJ~:7J~:A:i;;~i~~i:t~lt~i 7/~,
~,YjV , I
Certificate of acctipancy
24 hour notice for all inspections 447-9850
Special Conditions if any
City Planner
Date